T淋巴细胞、自然杀伤细胞和巨噬细胞在子宫内膜异位症在位内膜中的表达

目的通过观察子宫内膜异位症(endometriosis,EMs)患者在位内膜中免疫细胞CD45RO、CD3、CD4、CD8、CD56和CD68阳性细胞数量表达,探讨T淋巴细胞、自然杀伤细胞和巨噬细胞在子宫内膜异位症在位内膜中的表达变化以及意义;方法应用免疫组织化学染色方法,采用CD45RO、CD3、CD4、CD8、CD56、CD68单克隆抗体对45例EMs患者在位内膜中的阳性细胞进行标记,测定其在EM患者在位内膜中的表达数量。同期选取16例宫颈原位癌非EMs患者作为对照;结果 EMs组和对照组在位内膜中均有CD45RO、CD3、CD4、CD8、CD56和CD68阳性细胞表达,EMs组在位内膜中的CD45RO、CD8、CD68阳性细胞数量明显高于对照组,差异有统计学意义(P<0.05),CD3、CD4阳性细胞数量略高于对照组,差异无统计学意义(P>0.05),CD56阳性细胞数量较对照组无明显改变,差异无统计学意义(P>0.05)。CD4+/CD8+比值较对照组降低,差异有统计学意义(P<0.05)。两组患者分泌期内膜中CD45RO、CD3、CD4、CD8、CD56、CD68阳性细胞数量较增殖期增加,但差异无统计学意义(P>0.05);结论 EMs患者在位内膜中免疫细胞的数量变化影响机体免疫功能的改变,在EMs的发生、发展中起着重要作用。     

One‐Year Clinical Outcome of a Randomized Trial of Polymer‐Free Paclitaxel‐Eluting Stents Versus Biodegradable Polymer‐Based Rapamycin‐Eluting Stents in Patients with Coronary Heart Disease

Background: More widespread use of drug‐eluting stents (DES) to treat coronary heart disease (CHD) has recently generated more attention to thrombosis, which was relative to the polymer. Polymer‐free and biodegradable polymer‐based stents are more frequently studied, but their efficacy on preventing detrimental clinical events is unclear. Methods and Results: To assess whether polymer‐free paclitaxel‐eluting stent (YINYI stent) was noninferior or equivalent to biodegradable polymer‐based rapamycin‐eluting stents (EXCEL stent) in preventing detrimental clinical cardiovascular events, a total of 167 consecutive CHD patients requiring DES implantation were randomly divided into the YINYI group (n = 82) and the EXCEL group (n = 85). The primary end‐point was major adverse cardiac events (MACE). The secondary end‐points included stent thrombosis events, all‐cause mortality, and rehospitalization. The study was designed to test the noninferiority or equivalence of the YINYI stent compared with the EXCEL stent with respect to one‐year MACE according to a noninferiority or equivalence margin of 0.1. One‐year MACE was 6.10% in the YINYI group versus 5.88% in the EXCEL group. The lower limit of the one‐sided 95% confidence interval was ?0.0582 (P = 0.002 from the test for noninferiority). The 95% confidence interval for the equivalence test was [?0.0698, 0.0742] (P₁=0.004 and P₂=0.007 from 2 times the 1‐sided test for equivalence). There was no statistically significant difference in thrombosis events, all‐cause death, and rehospitalization (all P > 0.05). Conclusions: In this small randomized trial, polymer‐free paclitaxel‐eluting stents appear to be noninferior or equivalent to biodegradable polymer‐based rapamycin‐eluting stents. (J Interven Cardiol 2012;25:604–610)     

伴颞下颌关节紊乱病安氏Ⅱ类1分类错患者咀嚼运动中髁突轨迹分析

目的: 探讨伴颞下颌关节紊乱病（temporomandibular disorders,TMD）的安氏Ⅱ类1分类（Ⅱ¹）错患者咀嚼运动中髁突轨迹特征,进一步分析TMD和安氏Ⅱ¹错因素对咀嚼运动中髁突轨迹的影响。方法: 按照实验纳入标准分别收集无TMD的正常组（nTMD-N）10例、无TMD的安氏Ⅱ¹组（nTMD-Ⅱ¹）10例、伴TMD的安氏Ⅱ¹组（TMD-Ⅱ¹）14例患者。采用Cadiax Ⅳ 记录3组实验对象咀嚼运动时的髁突轨迹,利用GDSW软件测量并分析咀嚼运动轨迹的各项数据指标。采用SPSS 26.0软件包对所得结果进行统计学分析。结果: nTMD-Ⅱ¹组和TMD-Ⅱ¹组的咀嚼运动轨迹特征与nTMD-N组相比有所差异。左侧或右侧单侧咀嚼运动时,nTMD-N组、nTMD-Ⅱ¹组和TMD-Ⅱ¹组的各项数据无统计学差异。双侧咀嚼运动时,nTMD-Ⅱ¹组的SCI值显著大于nTMD-N组,nTMD-N组的S值显著大于nTMD-Ⅱ¹组（P<0.05)。结论: 单侧咀嚼运动时,TMD和安氏Ⅱ¹错因素对咀嚼运动轨迹影响较小。安氏Ⅱ¹类错因素对双侧咀嚼运动有影响,Ⅱ¹患者正常咀嚼时髁突整体运动幅度较正常者小。双侧咀嚼运动时,TMD对Ⅱ¹类患者咀嚼运动轨迹无明显影响。     

加贝酯预防内镜逆行胰胆管造影术后胰腺炎的实验研究

背景：急性胰腺炎是内镜逆行胰胆管造影术（ERCP）的常见并发症，加贝酯对ERCP术后胰腺炎的预防作用仍存在争议。目的：探讨加贝酯对大鼠ERCP术后胰腺炎的预防作用。方法：通过血压计传导50mmHg（1mmHg=0.133kPa）的恒定压力，向胰胆管内注入30％泛影葡胺，以制备SD大鼠ERCP术后胰腺炎模型。检测各组血清淀粉酶水平，并行胰腺组织病理学检查。结果：加贝酯治疗组的血清淀粉酶水平和胰腺组织炎症评分均显著低于胰腺炎对照组（P〈0.05）。结论：加贝酯静脉滴注对预防ERCP术后胰腺炎有效。     

踝臂指数和颈动脉斑块积分预测冠脉病变的价值

目的 探讨踝臂指数(ABI)和颈动脉斑块积分(Crouse积分)预测冠状动脉病变的价值.方法 选择2013年12月～2014年5月在解放军总医院心内科住院并首次行冠状动脉造影的194例患者,根据冠状动脉造影结果按病变狭窄程度(Gensini积分)分为严重病变组(64例)和非严重病变组(130例),分析ABI及颈动脉Crouse积分与冠脉病变的关系.结果 严重病变组和非严重病变组的ABI和颈动脉Crouse积分差异均有统计学意义(P＜ 0.05或P＜ 0.01);相关性分析结果,ABI与冠脉病变情况呈负相关(r=-0.518,P＜0.01),颈动脉Crouse积分与冠脉病变情况呈正相关(r=0.616,P＜0.01).ABI诊断严重冠脉病变的受试者工作特征曲线(ROC曲线)下面积为0.278,以ABI≤0.9为截断值,其预测冠脉严重病变的敏感性为23.4％,特异性为95.4％;颈动脉Crouse积分诊断严重冠脉病变的ROC曲线下面积为0.627,以颈动脉Crouse积分≥1.9为截断值,其预测冠脉严重病变的敏感性为70.3％,特异性为41.5％.结论 ABI和颈动脉Crouse积分与冠状动脉的病变程度密切相关,对于预测严重病变的冠状动脉,二者具有很高的应用价值.     

卵巢癌患者血清和腹水中树突状细胞相关miRNA水平分析

目的观察卵巢癌患者血清标本中与树突状细胞分化发育调控有关的miRNA水平及其与临床特征的关系,探讨血清中miRNA的检测在卵巢癌免疫状态及预后判断中的价值。方法采用实时荧光定量PCR技术检测39例卵巢癌患者腹水和血清及20例健康女性成年人血清中miRNA的水平。结果卵巢癌患者血清中miR-21、miR-222和miR-142-3p水平显著高于健康对照组,在临床Ⅲ~Ⅳ期卵巢癌患者血清中miR-21水平高于Ⅰ~Ⅱ期,病理分级高的卵巢癌患者血清中miR-142-3p水平低于低级别的患者,而且患者腹水中miR-21和miR-222的水平高于外周血。结论卵巢癌患者血清和腹水miR-21、miR-222和miR-142-3p水平升高,与临床分期病理分级有关。     

白细胞介素-23受体基因多态性与炎症性肠病关系的初步研究

目的 初步探讨白细胞介素-23受体(IL23R)基因中两个单链核苷酸多态性(SNP)位点(rs11209026和rs11805303)的遗传多态性和炎症性肠病(IBD)的发病易感性之间的关系.方法 采用聚合酶链反应(PCR)直接测序法检测50名健康人和81例IBD患者(其中克罗恩病41例,溃疡性结肠炎40例)的两个SNP位点基因多态性.结果 rs11209026位点基因型频率和等位基因频率在克罗恩病患者分别为7.3%和3.7%,在溃疡性结肠炎患者分别为15.0%和7.5%,在对照组分别为14.0%和7.0%,三组间差异均无统计学意义(P值均＞0.05).rs11805303位点的基因型频率和等位基因频率在克罗恩病患者分别为22.0%和52.4%,在溃疡性结肠炎患者分别为15.0%和41.2%,在对照组分别为34.0%和59.0%,三组间基因型频率比较差异均无统计学意义(P值均＞0.05),而等位基因频率在溃疡性结肠炎患者和对照组间差异有统计学意义(P=0.018).rs11805303位点基因多态性与溃疡性结肠炎患者的发病年龄、性别、疾病的活动性及发病部位均无关(P值均＞0.05).结论 IL23R两个SNP位点基因多态性与克罗恩病无相关性.rs11805303位点的多态性可能为溃疡性结肠炎患者的一个遗传标志,但与该病病变特点无显著相关.     

功能性胃肠病患者自评量表心理测评150例分析

目的 探讨功能性胃肠病(FGIDs)患者焦虑、抑郁性情绪障碍的心理过程及心理活动水平.方法 采用抑郁自评量表(SDS)和汉密顿焦虑量表(HAMA),对2007年4～11月南方医科大学南方医院消化科门诊收治的150例FGIDs患者,包括肠易激综合征(IBS)50例,功能性消化不良(FD)50例和胃食管反流病(GERD)50例及35名同期健康体检者进行心理测评.结果 150例FGIDs患者SDS评分≥50分者100例(66.7%),HAMA评分≥14分者59例(39.3%),与对照组比较差异有统计学意义(P<0.05),但3种疾病间差异无统计学意义(P>0.05).结论 FGIDs患者存在着明显的抑郁和焦虑精神心理障碍,因此,时FGIDs的诊治过程中临床医生应高度重视精神心理因素.     

Experimental reconstruction of dog's esophagus with biotype artificial esophagus

OBJECTIVE: At present, there are few materials available for esophagus reconstruction anywhere in the world. The reported survival rate in animals during the perioperative period is comparatively low. The present study assessed the feasibility of using a biotype artificial esophagus in the reconstruction of a dog's esophagus. METHODS: In 30 mongrel dogs, a portion of the thoracic esophagus was resected and an 8 cm section of artificial esophagus was transplanted to reconstruct the organ. The survival rate, food intake and process of healing were observed. RESULTS: Of the 30 dogs, 28 survived the peri­operative period (93.3% survival). Two dogs (6.7%) developed an anastomotic fistula; 19 dogs survived for 1 year, a survival rate of 79.2% (19/24) with the remaining six dogs were killed according to the experimental protocol. Detachment of the artificial esophagus occurred on average 28.8 days after operation and the dogs suffered from varying degrees of dysphagia 23?45 days after operation. Gradual remission occurred after 4 months. The histological study revealed that the regenerated esophagus was composed of fibrous and connective tissues and the luminal surface was covered with squamous epithelium in 3?6 months. CONCLUSION: The transplanted artificial esophagus detached after the surrounding ‘regenerated esophagus’ had formed, and the squamous epithelium gradually covered the luminal surface. Continuous remodeling of the ‘regenerated esophagus’ gradually relieved the stenosis. Whether detachment of the implant and the postoperative stenosis can be solved is the key problem restricting the use of the biotype artificial esophagus in clinical practice.     

Jasper电解可脱性弹簧圈治疗颅内动脉瘤的多中心临床试验研究

目的验证国内研发的Jasper颅内电解可脱性弹簧圈在栓塞颅内动脉瘤临床应用中的非劣效性。方法试验为前瞻性、多中心平行对照临床试验,方案由国家药品监督管理局审定。选择Hunt-Hess0～Ⅲ级的非宽颈颅内动脉瘤患者134例,其中使用Jasper弹簧圈(试验组)64例,使用电解可脱性弹簧圈(GDC)和Sapphire弹簧圈(对照组)70例。评估手术操作过程中,弹簧圈的临床性能(输送系统推送、定位、释放和回撤等操作的方便性与可靠性)及置入的成功率;术后1、6个月行改良Rankin评分;对术后即刻和6个月的造影结果进行评定;观察不良事件发生、再次蛛网膜下腔出血、死亡和卒中的发生率。结果①试验组共使用345枚Jasper弹簧圈,置入成功率为99.3%(344/345)。对照组为100%(304/304),两组弹簧圈的置入成功率和临床性能的比较差异均无统计学意义(P>0.05)。在试验过程中,两组均未出现弹簧圈脱落、血管痉挛、血栓形成、动脉瘤破裂、血管穿孔等并发症。②改良Rankin评分、不良事件发生率、再次蛛网膜下腔出血、死亡和卒中发生率两组比较,差异均无统计学意义(P>0.05)。③试验组术后即刻造影显示动脉瘤闭塞率为(95.4±6.4)%,不完全闭塞6例(9.4%),完全闭塞58例(90.6%);对照组术后动脉瘤闭塞率为(94.8±5.5)%,不完全闭塞5例(7.1%),完全闭塞65例(92.9%),两组比较差异均无统计学意义(P>0.05)。④试验组40例和对照组32例术后6个月获得血管造影随访。动脉瘤闭塞率两组差异无统计学意义(P>0.05)。结论应用Jasper颅内电解可脱性弹簧圈治疗颅内动脉瘤,具有与目前国外同类成熟产品相同的临床安全性和有效性。